What Is Polycystic Ovary Syndrome (PCOS)?

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Polycystic ovary syndrome (PCOS) is a common yet often overlooked medical condition in women of childbearing age. It impacts both the reproductive system and metabolic health due to the effects of excess male hormones and insulin. Menstrual irregularities, weight gain, acne, and excess hair growth are some common symptoms.

Knowing the facts about PCOS and what you can do about it can make it easier to live with and prevent long-term complications.

Polycystic Ovary Syndrome Symptoms

No two women with PCOS have the same exact experience with it, but common issues associated with this disease include:

Learning more about these and other signs and symptoms of PCOS and how they can be treated can help you make changes that leave you feeling better both emotionally and physically.

Causes

The underlying cause of PCOS is still unknown. Because it runs in families, there are likely genetic factors at work, as well as health and lifestyle ones.

PCOS is characterized by elevated androgen levels (male hormones like testosterone) in women resulting in an imbalance of sex hormones. This hormone imbalance can affect ovulation by causing irregular, absent, or heavy menstrual periods. Because of this, PCOS is the leading cause of ovulatory infertility.

PCOS is also associated with insulin resistance and obesity. Having higher insulin levels can contribute to weight gain and difficulties losing weight. If insulin is not well controlled, it can lead to more serious health issues such as metabolic syndrome and type 2 diabetes.

PCOS affects approximately 10% of women of childbearing age, making it the most common endocrine disorder in this stage of the lifecycle.

Diagnosis

PCOS is a condition of exclusion. Other conditions that cause similar symptoms need to be ruled out before making an accurate diagnosis.

If your primary care doctor suspects PCOS, you will likely be referred to a clinical endocrinologist or reproductive endocrinologist who will review your symptoms and do more testing, such as blood tests and an ultrasound of your ovaries. Results and your history will then be compared against a set of specific diagnostic criteria.

PCOS is often underdiagnosed or misdiagnosed for many reasons, especially because symptoms vary and cases present differently. It can take time to reach the correct diagnosis, and you may want a second opinion or further testing for assurance.

Despite the name polycystic ovary syndrome, women with PCOS don’t typically have cysts at all. Instead, tiny immature follicles surround the ovaries, appearing like a strand of pearls on an ultrasound. These follicles are the result (and not the cause) of an imbalance of sex hormones that inhibit follicles from maturing and being released for fertilization.

Many professionals feel the name PCOS is misleading and contributes to the challenge of getting more women diagnosed. A new name that doesn’t focus so much on cysts or ovaries, but rather on the metabolic aspects women with the condition are likely to experience, has been proposed: metabolic reproductive syndrome.

Treatment

Unfortunately, PCOS does not go away and there is not currently a cure. The good news is that PCOS can be treated and managed with lifestyle changes, medications, and specialist-driven procedures.

Diet and lifestyle changes are the primary treatment approach. Losing excess weight can reduce symptoms and may improve fertility. Eating a healthy diet can help with the metabolic symptoms and reduce the risks of complications. Staying active by doing some form of physical activity daily—like walking and weight training—is also critical. And getting enough sleep is important to keep insulin levels in check, help with mood and energy, and maintaining a normal circadian rhythm.

Medications for PCOS include using oral contraceptives to regulate the menstrual cycle and reduce androgens. Progestin therapy can also help, plus it may reduce the risk of endometrial cancer. Anti-androgen medications may be recommended as well. Metformin might be prescribed to address metabolic issues. If infertility is a concern, there are several treatment options.

You may be tempted to try things that have worked for other women with PCOS. But, remember, you are you. What’s right for your specific case will be determined during conversations with health professionals. And don’t be afraid to get more support, like working with a registered dietitian, nutritionist, or therapist.

A Word From Verywell

Getting diagnosed can lead to a variety of emotions, from feeling upset to validated that you finally have a name for what has been making you feel "off" and causing your symptoms. You may also feel overwhelmed with the information you were given and what to do about it. It’s important to give yourself time to adjust to the news and get more acquainted with the facts of your condition. Changes don’t have to be made immediately, even though it may feel like they should.

Learn about PCOS, work closely with your doctor, and set yourself on the best course for successfully managing your condition.

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  1. Mccartney CR, Marshall JC. CLINICAL PRACTICE. Polycystic Ovary Syndrome. N Engl J Med. 2016;375(1):54-64. doi:10.1056/NEJMcp1514916

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